NPI: 1467850404 · LONGVIEW, TX 75605 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 112 | $1K |
| 2021 | 899 | $10K |
| 2022 | 763 | $10K |
| 2023 | 1,491 | $21K |
| 2024 | 1,182 | $17K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,938 | 1,736 | $25K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,262 | 1,135 | $17K |
| V2784 | Lens polycarb or equal | 720 | 671 | $7K |
| V2025 | Eyeglasses delux frames | 245 | 212 | $6K |
| V2100 | Lens spher single plano 4.00 | 160 | 141 | $2K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 91 | 81 | $1K |
| V2799 | Misc vision item or service | 31 | 30 | $0.00 |